Systemic and Local Strategies for Primary Prevention of Breast Cancer

Abstract

One in eight women will develop breast cancer in the US. For women with moderate (15–20%) to average (12.5%) risk of breast cancer, there are few options available for risk reduction. For high-risk (>20%) women, such as BRCA mutation carriers, primary prevention strategies are limited to evidence-based surgical removal of breasts and/or ovaries and anti-estrogen treatment. Despite their effectiveness in risk reduction, not many high-risk individuals opt for surgical or hormonal interventions due to severe side effects and potentially life-changing outcomes as key deterrents. Thus, better communication about the benefits of existing strategies and the development of new strategies with minimal side effects are needed to offer women adequate risk-reducing interventions. We extensively review and discuss innovative investigational strategies for primary prevention. Most of these investigational strategies are at the pre-clinical stage, but some are already being evaluated in clinical trials and others are expected to lead to first-in-human clinical trials within 5 years. Likely, these strategies would be initially tested in high-risk individuals but may be applicable to lower-risk women, if shown to decrease risk at a similar rate to existing strategies, but with minimal side effects.

The association of breast cancer patients survival and prior menopausal hormone therapy in women with type 2 diabetes

“…The cumulative exposure of breast tissue to estrogen is a major risk factor for breast carcinogenesis, and the most known breast cancer risk factors, including younger age at menarche, older age at menopause, hormonal birth control medications, and prolonged systemic MHT, are linked to estrogen exposure 32 . In line with this, in high-risk genetic variant carriers, the most effective intervention to decrease breast cancer incidence and mortality is salpingo-oophorectomy, in addition to risk-reducing mastectomy 33 , 34 .…”

Modern Approaches and Future Perspectives on Breast and Ovarian Cancer Prevention Strategies in BRCA1 and BRCA2 Mutation Carriers: A Literature Overview

“…[40] Indeed, RANKL is a protein that has been shown to be expressed in the mammary gland during both developmental stages and the formation of tumors. [41] Therefore, the utilization of anti-RANKL monoclonal antibodies, like denosumab, presents a potential novel approach for breast cancer prevention in BRCA mutation carriers.…”

Beyond Milk and Nurture: Breastfeeding’s Powerful Impact on Breast Cancer

“…In the advancing and developed world breast cancer is a significant global challenge, impacting women 1 2 “considerably”. Each year, around 2.3 million breast cancer cases are diagnosed worldwide, contributing to a 19.6 million Disability-Adjusted Life Years (DALYs) for women 3 .…”